Microbiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.
Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain.
Front Public Health. 2022 Jul 22;10:880435. doi: 10.3389/fpubh.2022.880435. eCollection 2022.
The coronavirus disease 2019 (COVID-19) pandemic has been a worldwide stress test for health systems. 2 years have elapsed since the description of the first cases of pneumonia of unknown origin. This study quantifies the impact of COVID-19 in the screening program of chronic viral infections such as human papillomavirus (HPV), human immunodeficiency virus (HIV), and hepatitis C virus (HCV) along the six different pandemic waves in our population. Each wave had particular epidemiological, biological, or clinical patterns.
We analyzed the number of samples for screening of these viruses from March 2020 to February 2022, the new infections detected in the pandemic period compared to the previous year, the time elapsed between diagnosis and linking to treatment and follow-up of patients, and the percentage of late HIV diagnosis. Moreover, we used the origin of the samples as a marker for quantifying the restoration of activity in primary care.
During the first pandemic year, the number of samples received was reduced by 26.7, 22.6, and 22.5% for molecular detection of HPV or serological HCV and HIV status respectively. The highest decrease was observed during the first wave with 70, 40, and 26.7% for HPV, HCV, and HIV. As expected, new diagnoses also decreased by 35.4, 58.2, and 40.5% for HPV, HCV, and HIV respectively during the first year of the pandemic. In the second year of the pandemic, the number of samples remained below pre-pandemic period levels for HCV (-3.6%) and HIV (-9.3%) but was slightly higher for HPV (8.0%). The new diagnoses in the second year of the pandemic were -16.1, -46.8, and -18.6% for HPV, HCV, and HIV respectively.
Undoubtedly, an important number of new HPV, HCV, and HIV infections were lost during the COVID-19 pandemic, and surveillance programs were disrupted as a consequence of collapse of the health system. It is a priority to reinforce these surveillance programs as soon as possible in order to detect undiagnosed cases before the associated morbidity-mortality increases. New pandemic waves could increase the risk of reversing the achievements made over the last few decades.
2019 年冠状病毒病（COVID-19）大流行是对卫生系统的一次全球压力测试。自首次描述不明来源肺炎病例以来，已经过去了 2 年。本研究量化了 COVID-19 在我们人群中沿着六个不同的大流行波筛查慢性病毒感染（如人乳头瘤病毒（HPV）、人类免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV））的计划中的影响。每个波都有特定的流行病学、生物学或临床模式。
我们分析了 2020 年 3 月至 2022 年 2 月期间这些病毒的筛查样本数量，大流行期间新发现的感染与前一年相比，诊断与将患者链接到治疗和随访之间的时间，以及晚期 HIV 诊断的百分比。此外，我们使用样本来源作为量化初级保健活动恢复的标志物。
在大流行的第一年，HPV 或 HCV 和 HIV 状态的分子检测样本数量分别减少了 26.7%、22.6%和 22.5%。在第一波中观察到的降幅最大，HPV、HCV 和 HIV 分别为 70%、40%和 26.7%。正如预期的那样，HPV、HCV 和 HIV 的新诊断在大流行的第一年也分别下降了 35.4%、58.2%和 40.5%。在大流行的第二年，HCV（-3.6%）和 HIV（-9.3%）的样本数量仍低于大流行前水平，但 HPV 略高（8.0%）。大流行第二年的新诊断分别为 HPV（-16.1%）、HCV（-46.8%）和 HIV（-18.6%）。
毫无疑问，在 COVID-19 大流行期间，大量新的 HPV、HCV 和 HIV 感染被遗漏，卫生系统崩溃导致监测计划中断。当务之急是尽快加强这些监测计划，以便在相关发病率和死亡率增加之前发现未确诊病例。新的大流行波可能会增加逆转过去几十年所取得成就的风险。
